Understanding Sleep Disorders

While the field of sleep disorders still holds many unknowns, anyone who has been through multiple sleepless nights in a row can tell you that insomnia can have concerning ramifications. One night of insomnia, however will not have a major affect on your body. If you find yourself tossing and turning the night before a big exam or a speech, do not worry. The adrenaline from the excitement of the next day's big event will supersede any negative effects of the lack of sleep.

In contrast, many sleepless nights in a row will tend to adversely affect work productivity, social life, and physical health for most people. Some people can get by with as few as three hours of sleep a night and not feel tired at all the next day. The majority of people need at least six to eight hours and some need more than ten to feel rested. You know that sleeplessness has affected you when you feel over-tired and lose motivation to complete tasks. Your concentration and reaction time are somewhat altered. Monotonous activities like driving become hazardous because you feel yourself nodding off. If you are required to make critical decisions or to think creatively, your resources may be less than ideal. People who are chronically sleep deprived may experience impaired memory functioning and irritability.

What kind of insomniac are you? One system of categorizing insomniacs looks the potential causes of insomnia: (1) insomnia associated with emotional difficulties, (2) insomnia associated with physical ailments, (3) insomnia due to lifestyle behaviors, and (4) insomnia caused by poor sleep hygiene (sleep habits). Both depression and anxiety are psychological problems that affect sleep. Waking up too early is often a symptom of depression while having difficulty falling asleep is associated with anxiety. Drug and alcohol addictions can seriously interfere with the sleep cycle. Medical conditions affecting sleep include: pain, infections, breathing problems, allergies, hormone upsets, indigestion, and more. Insomnia can also be a side effect from certain medications. Ironically, sleeping pills can also contribute to sleep disorders. Lifestyle problems may involve overworking, relationship conflict, or lack of "play time." Poor sleep habits such as napping can also disrupt the sleep schedule.

In trying to deal with overcoming insomnia, start by investigating the cause of your problems. If you are experiencing depression, psychotherapy and antidepressants may help your sleep get back on track. If your lifestyle is not in balance, try cutting back on your obligations. If you have developed poor sleeping habits, you need to learn new bedtime associations to improve sleep.

Resource: No More Sleepless Nights (1991) by Peter Hauri and Shirley Linde

Sleeping Pills: A Short-Term

At one time physicians passed out sleeping pills and tranquilizers like candy. With new information about the long-term consequences of sleeping pill use, many people are being more cautious about what to take and for how long.

Once your body has learned to depend on pills for sleep, taking pills away usually causes the insomnia to get worse. This is called "rebound insomnia." Because of this phenomena, people often become addicted to sleeping pills. A sleeping pill can be masking the real causes of poor sleep (i.e., the medical, behavioral, or psychological problems). The National Institute of Health recommends that the treatment for insomnia should start with the corrections of poor sleep habits before sleeping medication is used. If the individual does choose to go on sleep medications, he or she should receive the smallest effective dose for the shortest clinically necessary period of time.

Sleeping pills can also affect the day after. People often take sleeping pills thinking that they will feel more refreshed and alert the next day. By contrast, research indicates people who got a night's sleep while on sleeping pills did not perform any better than people who got a poor night's sleep while on a placebo. Many people feel sedated and groggy after a night's sleep on medication.

All sleeping pills have been shown to have side effects. They cause confusion, high blood pressure, anxiety, dizziness and may slow respiration. Sleeping pills can interact with other drugs, and the combination with alcohol can be deadly.

"Sleep Hygiene": Behavioral Strategies

  • Don't sleep longer than you need to feel refreshed the next day
  • Use your bed only for sleeping and sex
  • Wind down with a relaxing activity before bed and lie down only when sleepy
  • Go to bed about the same time every day of the week
  • If you don't fall asleep in about 15 minutes, leave the room, do something boring and don't return to bed until you feel sleepy. Repeat the same procedure any time you are awake in bed for more than about 15 minutes (estimate the time, try not to watch the clock)
  • Get up at the same time every morning, seven days a week, regardless of how much sleep you had the night before
  • Don't take naps
  • Don't drink coffee after noon and don't drink alcohol at night.
  • Avoid nonprescription medications that contain caffeine or other stimulants
  • Exercise regularly about four times a week but don't do it too close to bedtime
  • Have a light snack before bed (e.g., ripe bananas and warm milk may help make you sleepy)
  • Limit your intake of liquids in the evening to decrease the need for middle of the night trips to the bathroom
  • Avoid sleeping pills as they only provide short-term relief

Additional Resources

  • Benson, H. B. (1975) The Relaxation Response. New York: William Morrow.
  • Hauri, P. & Linde, S. (1991). No More Sleepless Nights. New York: Wiley.
  • Lichstein, K. L. (1988) Clinical Relaxation Strategies. New York: Wiley.
  • Morin, C. M. (Ed) (1993). Insomnia. New York: Guilford Press.